THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE

Every year in the world, arterial hypertension is the cause of death in about 9 million cases. Blood pressure control in patients has not yet reached the appropriate level, and the percentage of resistant arterial hypertension remains high. According to the definition of the American Heart Associati...

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Main Authors: O. S. Kulbachuk, E. V. Sid, O. V. Soloviov, A. V. Piskun
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2023-03-01
Series:Сучасні медичні технології
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Online Access:https://zmapo-journal.com/index.php/journal/article/view/256
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author O. S. Kulbachuk
E. V. Sid
O. V. Soloviov
A. V. Piskun
author_facet O. S. Kulbachuk
E. V. Sid
O. V. Soloviov
A. V. Piskun
author_sort O. S. Kulbachuk
collection DOAJ
description Every year in the world, arterial hypertension is the cause of death in about 9 million cases. Blood pressure control in patients has not yet reached the appropriate level, and the percentage of resistant arterial hypertension remains high. According to the definition of the American Heart Association, those patients whose condition requires taking four or more drugs to control blood pressure should be considered resistant to treatment. It should be understood that uncontrolled hypertension is not synonymous with RAH. The presence of RAH significantly increases the risk of cardiovascular complications, contributes to serious damage to target organs. Preliminary diagnosis of RAH definitely requires the exclusion of secondary hypertension, which is a rather heterogeneous group of diseases that is poorly recognized. The goal of the work. To acquaint general practice - family medicine doctors with the algorithm of treatment of patients with resistant arterial hypertension at the ambulatory stage. Treatment of patients with RAH should be carried out in stages, with increased therapy, using the most simplified scheme of taking drugs. Today, the combination of ACEI (perindopril), BCC (amlodipine) and diuretic (indapamide) is considered as the most optimal triple combination of antihypertensive drugs. Medicines containing three antihypertensive drugs in one tablet are offered precisely for RAH patients. Conclusions. The implementation of the algorithm for the examination of patients with RAH, recommendations for changing their lifestyle and a step-by-step therapy plan allow improving the control of blood pressure. Treatment of patients with RAH should include optimization of dosages and the appointment of rational combinations of antihypertensive drugs in order to enhance synergistic effects. Optimization of pharmacotherapy by prescribing drugs with fixed combinations can improve control of drug administration. The fixed combination of amlodipine-indapamide-perindopril may have the important advantage of increasing treatment adherence due to the principle of "one pill per day".
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spelling doaj-art-2c054ed8772543be91db9c7d00f5293c2025-08-20T02:56:28ZengZaporizhzhia State Medical and Pharmaceutical UniversityСучасні медичні технології2072-93672023-03-011(56)697310.34287/MMT.1(56).2023.11256THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGEO. S. Kulbachuk0E. V. Sid1O. V. Soloviov2A. V. Piskun3State Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, UkraineState Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, UkraineState Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, UkraineState Institution «Zaporizhzhia Medical Academy of post-graduate education Ministry of Health of Ukraine», Zaporizhzhia, UkraineEvery year in the world, arterial hypertension is the cause of death in about 9 million cases. Blood pressure control in patients has not yet reached the appropriate level, and the percentage of resistant arterial hypertension remains high. According to the definition of the American Heart Association, those patients whose condition requires taking four or more drugs to control blood pressure should be considered resistant to treatment. It should be understood that uncontrolled hypertension is not synonymous with RAH. The presence of RAH significantly increases the risk of cardiovascular complications, contributes to serious damage to target organs. Preliminary diagnosis of RAH definitely requires the exclusion of secondary hypertension, which is a rather heterogeneous group of diseases that is poorly recognized. The goal of the work. To acquaint general practice - family medicine doctors with the algorithm of treatment of patients with resistant arterial hypertension at the ambulatory stage. Treatment of patients with RAH should be carried out in stages, with increased therapy, using the most simplified scheme of taking drugs. Today, the combination of ACEI (perindopril), BCC (amlodipine) and diuretic (indapamide) is considered as the most optimal triple combination of antihypertensive drugs. Medicines containing three antihypertensive drugs in one tablet are offered precisely for RAH patients. Conclusions. The implementation of the algorithm for the examination of patients with RAH, recommendations for changing their lifestyle and a step-by-step therapy plan allow improving the control of blood pressure. Treatment of patients with RAH should include optimization of dosages and the appointment of rational combinations of antihypertensive drugs in order to enhance synergistic effects. Optimization of pharmacotherapy by prescribing drugs with fixed combinations can improve control of drug administration. The fixed combination of amlodipine-indapamide-perindopril may have the important advantage of increasing treatment adherence due to the principle of "one pill per day".https://zmapo-journal.com/index.php/journal/article/view/256blood pressureresistant hypertensionantihypertensive drugsperindoprilamlodipineindapamide
spellingShingle O. S. Kulbachuk
E. V. Sid
O. V. Soloviov
A. V. Piskun
THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE
Сучасні медичні технології
blood pressure
resistant hypertension
antihypertensive drugs
perindopril
amlodipine
indapamide
title THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE
title_full THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE
title_fullStr THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE
title_full_unstemmed THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE
title_short THE ALGORITHM FOR THE TREATMENT OF PATIENTS WITH TREATMENT-RESISTANT HYPERTENSION AT THE OUTPATIENT STAGE
title_sort algorithm for the treatment of patients with treatment resistant hypertension at the outpatient stage
topic blood pressure
resistant hypertension
antihypertensive drugs
perindopril
amlodipine
indapamide
url https://zmapo-journal.com/index.php/journal/article/view/256
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